Department of Therapeutic Endoscopy, Nihonkai General Hospital, Yamagata, Japan.
Dig Endosc. 2012 May;24 Suppl 1:117-20. doi: 10.1111/j.1443-1661.2012.01266.x.
Secure manipulation of forceps in endoscopic submucosal dissection (ESD) for colorectal tumors is sometimes hindered by the characteristics of that organ. SB knife Jr, which are scissor forceps using a mono-pole high frequency, were developed to avoid the difficulty of ESD operation in the colorectum. The aim of the present study was to examine the effectiveness of the SB knife Jr in colorectal ESD in 11 hospitals, mostly in northeastern Japan.
One hundred and two colorectal tumors (49 non-granular laterally spreading tumor [LST] lesions, 39 granular LST lesions and 14 other lesions) that were resected by ESD operations using SB knife Jr between October 2009 and March 2010.
All tumors (102/102) were resected en bloc and could be observed in detail. The mean size of the resected pieces was 40.3 mm. The mean operation time was 54.2 min. Of the complications, one case of micro-perforation occurred during the manipulation of submucosal dissection, and this case was treated with clips in that operation. The rates of resection carried out only with SB knife Jr were 74.5% (76/102).
The novel ESD using SB knife Jr in the colorectum offers a breakthrough in resection techniques for not only expert endoscopists but also general endoscopists.
在结直肠肿瘤的内镜黏膜下剥离术(ESD)中,有时由于该器官的特点,钳子的稳固操作会受到阻碍。为了避免结直肠 ESD 操作的困难,开发了使用单极高频的 SB 刀 Jr,这是一种剪刀式钳子。本研究的目的是在日本东北部的 11 家医院(主要是在日本东北部)检验 SB 刀 Jr 在结直肠 ESD 中的有效性。
2009 年 10 月至 2010 年 3 月期间,使用 SB 刀 Jr 对 102 个结直肠肿瘤(49 个非颗粒侧向扩展肿瘤[LST]病变、39 个颗粒 LST 病变和 14 个其他病变)进行 ESD 手术切除。
所有肿瘤(102/102)均整块切除并可详细观察。切除标本的平均大小为 40.3mm。平均手术时间为 54.2 分钟。在黏膜下剥离操作过程中,有 1 例出现微小穿孔并发症,该病例在该手术中使用夹闭进行治疗。仅使用 SB 刀 Jr 进行切除的比例为 74.5%(76/102)。
新型的 SB 刀 Jr 结直肠 ESD 为不仅为专家内镜医生,也为普通内镜医生提供了结直肠肿瘤切除技术的突破。